This site is intended only for healthcare professionals residing in Malaysia




Log Out Our medicinesTherapy AreaExplore contentExplore contentEventsDownloadable materialsVideosLet’s connectLet's ConnectContact usPfizer medical information



RTIs & Acute Otitis MediaUpper Respiratory Tract Infections (Upper RTIs)Acute Bacterial SinusitisPharyngitis/TonsillitisAcute Otitis MediaAcute Otitis MediaLower Respiratory Tract Infections (Lower RTIs)Community-Acquired PneumoniaAcute Bacterial Exacerbation of Chronic BronchitisSTIsSexually Transmitted Infections (STIs)Infections by Chlamydia trachomatisInfections by Neisseria gonorrhoeaeChancroid/Genital Ulcers MenSSTIsSkin and Soft-Tissue Infections (SSTIs)Uncomplicated Skin and Soft-Tissue InfectionsSafetySafetySafetyAdditional InformationAdditional InformationIndication and SusceptibilityFormulationsMode of ActionReconstitution of Powder for Oral Suspension for PediatricsPediatric AdministrationResourcesResourcesPrescribing InformationEventsMaterialsVideos

RTIs & Acute Otitis Media  |  Lower Respiratory Tract Infections  |  Acute Bacterial Exacerbation of Chronic Bronchitis

Acute Bacterial Exacerbation of Chronic Bronchitis




Risk Factors

Tab Number 5



500 mg once daily for 3 days, or an alternative of 500 mg on Day 1, then 250 mg daily on Days 2-5

  • ZITHROMAX should be given as a single daily dose1
  • ZITHROMAX tablets and suspension can be taken with or without food1
Renal Impairment1

No dose adjustment is necessary in patients with mild to moderate renal impairment (glomerular filtration rate [GFR] of 10–80 mL/min). Caution should be exercised when ZITHROMAX is administered to patients with severe renal impairment (GFR <10 mL/min)

Hepatic Impairment1

The same dosage as in patients with normal hepatic function may be used in patients with mild to moderate hepatic function

PathogensMain Bacterial Pathogens2

Mild-to-moderate exacerbations:

  • Streptococcus pneumoniae
  • Haemophilus influenzae
  • Moraxella catarrhalis
  • Chlamydia pneumoniae
  • Mycoplasma pneumoniae

Severe exacerbations:

  • Pseudomonas species
  • Other Gram-negative enteric bacilli

Chronic obstructive pulmonary disease (COPD) exacerbations are caused by complex interactions between the host, respiratory viruses, and airway bacteria, which lead to an increase in the inflammatory burden within the airway3

Bacterial infection is a factor in 70–75% of exacerbations, with up to 60% caused by S. pneumoniae, H. influenzae, or M. catarrhalis2

Risk Factors4
  • COPD
  • Bacterial, viral, and atypical pathogens
  • Environmental conditions (e.g., air pollution and tobacco smoke)
  • Lack of compliance with COPD therapies
  • Worsening congestive heart failure or pulmonary embolism
EfficacyZITHROMAX – Effective, once-daily dosing in acute bacterial exacerbations of chronic bronchitis5 Favorable Response to Therapy at Day 4

Adapted from Amsden et al. 20035

Respiratory Pathogen Eradication Rates at Follow-Up (Day 24)*

Adapted from Amsden et al. 20035
*Values given as number of patients in whom pathogens were eradicated/total number of patients (%).

Amsden et al. 20035
  • A randomized, double-blinded, double-dummy, multicenter trial with 1:1 treatment allocation, comparing the safety and efficacy of oral azithromycin and levofloxacin in the treatment of outpatients with acute bacterial exacerbations of chronic bronchitis (ABECB)
  • Both treatments were well tolerated. Favorable clinical outcomes were 89% for azithromycin and 92% for levofloxacin by Day 4. At Day 24, responses were 82% and 86%, respectively, and eradication rates of respiratory pathogens were 96% for azithromycin and 85% for levofloxacin
  • A standard 5-day course of oral azithromycin was clinically and bacteriologically equivalent to a 7-day course of oral levofloxacin in the treatment of patients with ABECB
ZITHROMAX is contraindicated in patients with a known hypersensitivity to azithromycin, erythromycin, any macrolide or ketolide antibiotic, or to any of the excipients.1
Use of ZITHROMAX should be undertaken with caution in patients with significant hepatic disease. Abnormal liver function, hepatitis, cholestatic jaundice, hepatic necrosis, and hepatic failure have been reported, some of which have resulted in death.1
In patients with severe renal impairment (GFR <10 mL/min), a 33% increase in systemic exposure to ZITHROMAX was observed.1
You might also be interested in...Lower Respiratory Tract Infections Community-Acquired Pneumonia Find out moreLoadingResources ZITHROMAX® Mode of Action Find out moreLoadingReferences:Pfizer Malaysia ZITHROMAX Prescribing Information. Available at: Accessed January 2024.Hunter M, et al. Am Fam Phys. 2001;64:603–12.Aaron SD, et al. BMJ. 2014;349:g5237.Albertson TE, et al. Expert Rev Resp Med. 2009;3(5):539–48.Amsden GW, et al. Chest. 2003;123:772–7.
Lower Respiratory Tract Infections ZITHROMAX® Safety Information Find out more Loading
PfizerPro AccountPfizerPro Account

To access further materials, resources and receive communication about medicines and vaccines promoted by Pfizer.

Sign inRegisterAccountSign Out

This site is intended only for healthcare professionals residing in Malaysia. If you are a member of public wishing to access information on a specific medicine, please consult with your doctor.


This website is brought to you by
Pfizer (Malaysia) Sdn Bhd 197801003134
Level 10 & 11, Wisma Averis (Tower 2),
Bangsar South, No. 8, Jalan Kerinchi, 
59200 Kuala Lumpur, Malaysia.
Tel: 603-2281 6000 
Fax: 603-2281 6388 

Copyright © 2023 Pfizer Limited. All rights reserved.


You are now leaving the PfizerPro Malaysia website
You are now being directed to a third-party website. It is clarified that Pfizer will not be collecting, storing, or accessing any personal information shared by you on the third-party website and Pfizer's Privacy Policy will not apply. Pfizer does not review or control or endorse the content of the third-party website and shall have no liability / assumes no responsibility for any issues arising out of you accessing the third-party website, accuracy of the information, practices, and standards of the third-party website. You will be bound by the Privacy Policy and Terms of Use of the third-party website and be solely responsible for your interactions with that website.
     PP-UNP-MYS-0077 - 10FEB2023